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1.
Yonsei Medical Journal ; : 56-65, 2022.
Article in English | WPRIM | ID: wpr-919613

ABSTRACT

Purpose@#Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, and Th17 cells are key factors in the pathogenesis of human inflammatory conditions, such as RA. Catalpol (CAT), a component in Rehmanniae Radix (RR), has been found to regulate human immunity. However, the effects of CAT on Th17 cell differentiation and improvement of RA are not clear. @*Materials and Methods@#Collagen-induced arthritis (CIA) mice were constructed to detect the effects of CAT on arthritis and Th17 cells. The effect of CAT on Th17 differentiation was evaluated with let-7g-5p transfection experiments. Flow cytometry was used to detect the proportion of Th17 cells after CAT treatment. Levels of interleukin-17 and RORγt were assessed by qRT-PCR and enzyme-linked immunosorbent assay. The expression of signal transducer and activator of transcription 3 (STAT3) was determined by qRT-PCR and Western blot. @*Results@#We found that the proportion of Th17 cells was negatively associated with let-7g-5p expression in CIA mice. In in vitro experiments, CAT suppressed traditional differentiation of Th17 cells. Simultaneously, CAT significantly decreased Tregs-to-Th17 cells transdifferentiation. Our results demonstrated that CAT inhibited Tregs-to-Th17 cells transdifferentiation by up-regulating let-7g-5p and that the suppressive effect of CAT on traditional differentiation of Th17 cells is not related with let-7-5p. @*Conclusion@#Our data indicate that CAT may be a potential modulator of Tregs-to-Th17 cells transdifferentiation by up-regulating let-7g-5p to reduce the expression of STAT3. These results provide new directions for research into RA treatment.

2.
Article in Chinese | WPRIM | ID: wpr-910445

ABSTRACT

Objective:Ameloblastoma (AM) is a rare tumor derived from dental epithelial tissues, which is prone to recurrence and infiltration. This study aims to identify the prognostic factors of AM.Methods:207 ameloblastoma patients were screened from the SEER database. A Cox regression model and nomogram were constructed to evaluate the factors on the overall survival. Clinical data of 61 patients admitted to Hunan Cancer Hospital were retrospectively analyzed. The independent factors of recurrence rate were analyzed by the Cox regression model.Results:The results on the SEER database showed that age, tumor size, type of surgery, radiotherapy were important prognostic factors of the overall survival. The nomogram was constructed and the C-index was equaled to 0.821, indicating this model was moderately accurate. The receiver operating characteristic (ROC) curve demonstrated that the area under the ROC curve (AUC) at 1, 3, 5, and 10 years were 0.852, 0.869, 0.856, and 0.879, indicating this model had relatively high sensitivity and specificity. Kaplan- Meier survival analysis suggested that overall survival in the high-risk group was significantly lower than that in the low-risk group ( P<0.001). Based on retrospective analysis, clinical symptoms and type of surgery were the independent factors of the local recurrence rate. Kaplan- Meier survival analysis found the recurrence rate of facial swelling and pain was lower compared to those of other symptoms. Compared with the palliative surgery, radical surgery could decrease the recurrence rate. Conclusions:Age, tumor size, type of surgery, and radiotherapy may be important factors of the overall survival. Type of surgery and clinical symptoms are probably the independent factors of the recurrence rate.

3.
Article in Chinese | WPRIM | ID: wpr-906397

ABSTRACT

Objective:To explore the distribution characteristics of traditional Chinese medicine (TCM) syndromes of abnormal uterine bleeding associated with ovulatory dysfunction (AUB-O). Method:A clinical and epidemiological investigation was conducted in 6 688 patients with AUB-O from the provincial, municipal, and county/district hospitals in 29 provinces, autonomous regions, and municipalities across China to identify the distribution characteristics of their TCM syndromes. Result:The AUB-O patients nationwide were mainly differentiated into the kidney Qi deficiency syndrome (17.34%), the spleen Qi deficiency syndrome (13.25%), the Qi and blood deficiency syndrome (12.62%), the Qi deficiency and blood stasis syndrome (8.45%), and the kidney Yin deficiency syndrome (6.88%). AUB-O resulted from Qi deficiency, Yin deficiency, and blood deficiency, often involving the kidney, spleen and liver. The analysis of the regional distribution of TCM syndromes in AUB-O patients revealed that kidney Qi deficiency, spleen Qi deficiency, and Qi and blood deficiency were the shared syndromes. However, due to regional discrepancy, the TCM syndrome varied widely from one geographic region to another. The kidney Qi deficiency syndrome was more frequently seen in North China, Northwest China, Southwest China, and East China, but less frequently in central China, Northeast China, and South China. The spleen Qi deficiency syndrome occurred most frequently in central China, while the East China had the highest frequency of Qi and blood deficiency syndrome. The spleen and kidney deficiency syndrome was mostly present in central China, North China, and Southwest China, the Qi deficiency (kidney deficiency) and blood stasis syndrome in Northwest China, South China, and North China, the kidney Yin deficiency syndrome in East China, Northwest China, and Northeast China, the deficiency-heat syndrome in Southwest China and East China, the kidney Yang deficiency syndrome in South China, the liver depression and blood heat syndrome in Northeast China, and the liver depression and spleen deficiency syndrome in central China. The diagnostic criteria for the kidney Qi deficiency, spleen Qi deficiency, Qi and blood deficiency, Qi deficiency and blood stasis, and kidney Yin deficiency syndromes were not significantly different from the previous ones. The distinctive symptoms for the kidney Qi deficiency syndrome were irregular vaginal bleeding, heavy menstrual flow, or shortened menstrual cycle, back soreness and pain, and forgetfulness, while those for the spleen Qi deficiency syndrome mainly included the shortened menstrual cycle, mental fatigue, lack of strength, poor appetite, loose stool, and white tongue coating. The Qi and blood deficiency syndrome were mainly manifested as the shortness of breath, laziness to speak, pale complexion, dizziness, and palpitation. The Qi deficiency and blood stasis syndrome were mainly judged by the scanty menstrual flow frequently or occasionally accompanied by blood clots, mental fatigue, lack of strength, and dark purple tongue. The ovulatory bleeding, dizziness, tinnitus, vexing heat in chest, palms and soles, and night sweat were the characteristic signs for the kidney Yin deficiency syndrome. Conclusion:There exist certain rules in the geographical distribution of TCM syndromes of AUB-O patients, which has provided a reference for the clinical treatment of AUB-O in accordance with the local conditions.

4.
Article in English | WPRIM | ID: wpr-921398

ABSTRACT

Drug-induced pemphigus (DIP) is a special type of pemphigus, and its pathogenesis, characteristics of treatment, and prognosis are closely related to the inducing drugs. This article reports the diagnosis and treatment of DIP (pemphigus vulgaris) caused by the administration of rifampin to a patient with tuberculosis. Combined with the literature, we discussed the types, pathogenesis, differential diagnosis, and treatment principles of DIP. We propose that in the oral clinical practice for patients with pemphigus vulgaris, the importance of investigating suspected drugs that induce DIP should be emphasized.


Subject(s)
Diagnosis, Differential , Humans , Pemphigus/drug therapy , Pharmaceutical Preparations , Prognosis
5.
Chinese Journal of Radiology ; (12): 250-256, 2021.
Article in Chinese | WPRIM | ID: wpr-884419

ABSTRACT

Objective:To investigate the value of artificial intelligence (AI)-assisted quantitative measurement in evaluation of the dynamic changes of CT for COVID-19 pneumonia.Methods:The clinical and chest CT dynamic imaging data of 99 patients with confirmed COVID-19 pneumonia who were hospitalized in Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 15, 2020 to March 10, 2020 were retrospectively analyzed. According to the definitive diagnosis, the 99 patients were classified into common ( n=36), severe ( n=33) and critical ( n=30) type, the CT imaging findings of each type were analyzed, including CT basic signs, total volume of pneumonia lesions and percentage of pneumonia lesions of the total lung volume (volume ratio). AI software was used to quantitatively evaluate the dynamic changes of chest CT images. The quantitative indicators included CT peak time of lesions, total volume of lesions peak, volume ratio of lesions peak, maximum growth rate of total volume and maximum growth rate of volume ratio. Kruskal-Wallis rank sum test was used to compare the difference of quantitative indexes between the 3 types, and χ 2 test or Fisher exact probability test was used to compare the difference of qualitative indexes between the 3 types. Sequence measurement and scatter plots were used to show the evolution trend of the volume ratio of the three types of COVID-19 pneumonia lesions. The ROC curve was used to analyze the value of the volume ratio of pneumonia lesions and its maximum growth rate in predicting the conversion of common pneumonia to severe or critical pneumonia. Results:There were statistically significant differences in age and gender distribution among patients with common, severe and critical COVID-19 ( P<0.05), the age of severe and critical types were significantly higher than that of common type ( P<0.01). Compared with common [2.5 (1.0, 5.0) d] and critical type[2.5 (1.0, 4.0) d], the time from onset to the first chest CT scan of severe type was prolonged [5.0 (2.5, 8.0) d, P<0.01]. There were statistically significant differences in involvement of multiple lung lobes (20 cases, 29 cases, 25 cases, χ2=10.403, P=0.006) in patients with common, severe and critical COVID-19 at the first scan, the incidence of the involvement of multiple lung lobes in severe and critical types was significantly higher than that of common type ( P=0.002). The volume ratios of patients with common, severe and critical COVID-19 at the first scan were statistically significant [1.0% (0.2%, 4.7%), 9.30% (1.63%, 26.83%), 2.10% (0.64%, 8.61%), Z=14.236, P=0.001], and the volume ratio of severe type was significantly higher than that of common type ( P<0.001), there was no statistically significant difference between common type and critical type ( P=0.062). Follow-up CT showed that the pneumonia lesions showed a dynamic transformation of progress and recovery, and it was seen that the coexistence of multiphase lesions. The trend line in the scatter plot of the three types of COVID-19 pneumonia lesions showed that the lesions in the advanced stage developed from less to more. The lesion peak volume ratios of the common, severe and critical types were 9.75% (4.83%, 13.18%), 29.80% (23.99%, 42.36%) and 61.81% (43.73%, 72.82%), respectively, the difference was statistically significant ( Z=74.147, P<0.001). The maximum growth rates of lesion volume ratio were 1.27% (0.50%, 1.81%)/d, 4.39% (3.16%, 5.54%)/d and 6.02% (4.77%, 9.96%)/d, respectively, the difference was statistically significant ( Z=52.453, P<0.001). The peak times of lesions were 12.0 (9.0, 15.0) d, 13.0 (10.0, 16.0) d and 16.5 (12.0, 25.0)d, respectively, the difference was statistically significant ( Z=9.524, P=0.009). Taking the volume ratio of pneumonia lesion 22.60% and the maximum growth rate of the volume ratio 1.875%/d as the boundary value, the sensitivity of diagnosing common type to severe or critical type was 92.10% and 96.83%, and the specificity was 100% and 80.56%, respectively. The area under the curve was 0.987 and 0.925, respectively. Conclusions:The lesions of COVID-19 pneumonia show a similar parabolic change on CT imaging. The use of AI technology to dynamitcally and accurately measure the CT pneumonia lesion volume ratio is helpful to evaluate the severity of the disease and predict the development trend of the disease. Patients with a rapid growth of volume ratio are more likely to become severe or critical type.

6.
Article in Chinese | WPRIM | ID: wpr-870466

ABSTRACT

Objective:To investigate the feasibility, indication selection and treatment of Catheter- directed thrombolytic therapy with endovascular angioplasty for TASC- D type aorto- iliac artery occlusive diseases.Methods:From Jan 2014 to Jun 2017, the clinical data of 27 patients (33 limbs) with TASC- D type aorto- iliac artery occlusive diseases were analyzed retrospectively.Results:After catheter embolization , 31 limbs were successfully treated with endovascular angioplasty, the success rate was 93.9% (31/33). ankle brachial index (ABI) of successful limbs improved from (0.47±0.09) preoperatively to (0.80±0.11) postoperatively ( P<0.01). The patency rates of 6、12、24 months were 90.32%, 80.65%, 77.42%. One case (3.85%)suffered hematoma.There were no other major complications such as iliac artery rupture, arteriovenous fistula, deep vein thrombosis or pseudoaneurysm. Conclusions:Catheter-directed thrombolytic therapy can effectively reduce artery lumen thrombosis volume. Catheter- directed thrombolytic therapy with endovascular angioplasty for TASC- D type aorto- iliac artery occlusive diseases is a safe and effective treatment.

7.
Chinese Herbal Medicines ; (4): 214-223, 2020.
Article in Chinese | WPRIM | ID: wpr-842010

ABSTRACT

Kadsura coccinea belongs to medicinally important genus Kadsura from the Schisandraceae family. It has been used in traditional Chinese medicine (TCM) for the treatment of rheumatoid arthritis and gastroenteric disorders. The initial phytochemical work focused on the identification of some structurally novel and diverse natural products, which turned the attention of many researchers towards this plant. Thus far, 202 compounds have been reported in this plant. Lignans and terpenoids were found as the main chemical constituents of this plant. Some of the triterpenoids and sesquiterpenoids with novel structures are of particular interest for natural product researchers. The isolated compounds of this plant have shown different bioactivities including anti-tumor, anti-HIV, anti-inflammatory, nitric oxide (NO) production inhibitory and other pharmacological effects. This review systematically summarizes all the phytochemical and pharmacological work done so far on K. coccinea, and can be used as a reference for future research on this plant.

8.
China Pharmacy ; (12): 1061-1067, 2020.
Article in Chinese | WPRIM | ID: wpr-821494

ABSTRACT

OBJECTIVE:To establis h the fingerprint of Lonicera japonica polysaccharide,and to investigate in vitro inhibitory effect of it on respiratory syndrome virus (RSV). METHODS :Polysaccharide from L. japonica was prepared by water extraction and twice alcohol precipitation method. After hydrolysis with trifluoroacetic acid ,derivatization with hydroxylamine hydrochloride and pyridine ,the fingerprint was established by GC method. The determination was performed on HP- 5 capillary column ,and the detector was flame ionization detector ;the temperature of the sample inlet was 250 ℃;the temperature of the detector was 300 ℃ (programmed temperature );the carrier gas was nitrogen (flow rate of 50 mL/min);split sampling was adopted (split ratio of 60∶1);the sample size was 2.0 μL. Using rhamnose as reference substance,GC fingerprint of 12 batches of L. japonica (S1-S12) was drawn ,and the similarity evaluation was performed with Similarity Evaluation System of TCM Fingerprint (2012 edition). Cluster analysis and principal component analysis were conducted by using SPSS 21.0 software. Using ribavirin as positive control , half effective concentration (EC50)and treatment index (TI)as indexes ,MTT assay was used to investigate in vitro inhibitory effect of L. japonica polysaccharide on RSV. RESULTS :There were 12 common peaks in GC fingerprint of 12 batches of L. japonica. The similarity was greater than or equal to 0.994. Seven common peaks were identified ,such as rhamnose ,arabinose, fucose,mannose,glucose,galactose,inositol hexaacetate. According to the cluster analysis ,12 batches of samples could be divided into two categories ,i.e. S 1,S7,S10 and S 11 clustered into one category ,and others clustered into one category. In principal component analysis ,the eigen values of 3 principal components were all greater than 1 (5.659,2.745,1.724 respectively),and their cumulative contribution rate was 84.400%. The comprehensive score of S 12 was the highest ,the second was S 5,and the lowest was S 11. EC 50 of total polysaccharide ,80% alcohol precipitated polysaccharide ,50% alcohol precipitated polysaccharide and 20% alcohol precipitated polysaccharide of L. japonica (No. S 12) were 0.76,0.61,1.03,3.04 g/L, respectively;TI were 15.36,18.51,11.69,4.22,respectively. EC 50 of 80% ethanol alcohol precipitated polysaccharide was the lowest,and its TI was close to that of positive control (20.08). CONCLUSIONS :Established fingerprint provides reference for the quality evaluation of L. japonica . L. japonica polysaccharide has a certain inhibitory activity on RSV in vitro ,and the 80% alcohol precipitated polysaccharide has the strongest activity.

9.
Article in English | WPRIM | ID: wpr-827416

ABSTRACT

OBJECTIVES@#To evaluate the application value of CT-based radiomics features for the ascending and descending types of nasopharyngeal carcinoma (NPC).@*METHODS@#A total of 217 NPC patients (48 ascending type and 169 descending type), who obtained CT images before radiotherapy in Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from February 2015 to October 2017, were analyzed retrospectively. All patients were randomly divided into a training set (=153) and a test set (=64). Gross tumor volume in the nasopharynx (GTVnx) was selected as regions of interest (ROI) and was analyzed by radiomics. A total of 1 300 radiomics features were extracted via IBEX. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the significant features. Support vector machine (SVM) and random forest (RF) classifiers were built and verified.@*RESULTS@#Six features were selected by the LASSO from 1 300 radiomics features. Compared with SVM classifier, RF classifier showed better classification performance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were 0.989, 0.941, 1.000, and 0.924, respectively for the training set; 0.994, 0.937, 1.000, and 0.924, respectively for the validation set.@*CONCLUSIONS@#CT-based radiomics features possess great potential in differentiating ascending and descending NPC. It provides a certain basis for accurate medical treatment of NPC, and may affect the treatment strategy of NPC in the future.


Subject(s)
Humans , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , ROC Curve , Retrospective Studies , Sensitivity and Specificity
10.
Article in Chinese | WPRIM | ID: wpr-745435

ABSTRACT

Objective To observe the hematological toxicity of 89SrCl2 in patients with multiple bone metastases of malignant tumors,and analyze the related-risk factors.Methods A total of 89 patients (63 males,26 females;age:(62.3±5.2) years) with multiple bone metastases and treated with 89SrCl2 were enrolled.Hematological data at 2 and 4 weeks after treatment with 89SrCl2 were analyzed.Common Terminology Criteria for Adverse Events (CTCAE) v4.03 was used to evaluate the hematological toxicity,and the influencing risk factors were analyzed.Logistic regression analysis was used to analyze the data.Results The incidences of grade Ⅰ-Ⅱ anemia,leukopenia and thrombocytopania at 2 and 4 weeks after treatment were 15.7%(14/89),18.0%(16/89),11.2%(10/89) and 18.0%(16/89),24.7%(22/89),18.0%(16/89),respectively.The incidences of grade Ⅲ-Ⅳ anemia,leukopenia and thrombocytopenia were 2.2%(2/89),0,0 and 2.2%(2/89),2.2%(2/89),3.4%%(3/89),respectively.Logistics multivariate analysis showed that the number of bone metastases and the Hb level before treatment were independent effect factors for hematological toxicity of 89SrCl2,with odds ratio (OR) values of 2.200(95% CI:1.269-3.841) and 0.961 (95% CI:0.932-0.991),respectively.Conclusions Serious hematological toxicity after 89SrCl2 treatment is rare.The number of bone metastases and the Hb level before treatment are independent effect factors for hematological toxicity.

11.
Article in Chinese | WPRIM | ID: wpr-776272

ABSTRACT

OBJECTIVE@#To observe the effects on hippocampal neuronal structure and hippocampal monoamine neurotransmitters such as norepinephrine (NE), 5-hydroxytryptamine (5-HT) and dopamine (DA) with acupuncture for promoting the circulation of the governor vessel and regulating the mental state ( acupuncture) in rats with post-stroke depression and explore the underlying effect mechanism of acupuncture on post-stroke depression.@*METHODS@#A total of 48 clean-grade SD rats were randomized into a sham-operation group, a model group, a Tongdu Tiaoshen acupuncture group and a non-meridian-non-acupoint group, 12 rats in each one. In the model group, the Tongdu Tiaoshen acupuncture group and the non-meridian-non-acupoint group, the compound method of cerebral medial arterial occlusion and the chronic unpredictable mild stress was adopted to prepare the model of post-stroke depression. In the sham-operation group, skin was opened and the fascia muscle was separated, after artery exposed, no ligation was operated and the incision was sutured directly. In the sham-operation group and the model group, no any intervention was performed. In the Tongdu Tiaoshen acupuncture group, acupuncture was applied to "Baihui" (GV 20), "Shuigou" (GV 26), "Shenting" (CV 24) and "Dazhui" (GV 14) for 40 min in each treatment and the needles were manipulated at the acupoints once in 20 min. The treatment was given once a day, 6 times a week for 4 weeks consecutively. In the non-meridian-non-acupoint group, the depression between the 3rd and 4th metatarsal bones on the dorsum of the forelimb was selected in intervention and the needling technique was same as the Tongdu Tiaoshen acupuncture group. The behavioral changes were observed after intervention in each group. Using transmission electron microscopy, the ultrastructure of hippocampal CA 1 neurons was observed in the rats of each group. Using high performance liquid chromatography, the contents of NE, 5-HT and DA were determined.@*RESULTS@#Compared with the sham-operation group, the Zea-longa neurobehavioral score was increased (<0.01), the sucrose water consumption was reduced (<0.01), the number of times of horizontal movement and vertical movement in open-field test were reduced (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was aggravated and the contents of NE, 5-HT and DA were reduced in the model group (<0.01). Compared with the model group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05). Compared with the non-meridian-non-acupoint group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05).@*CONCLUSION@#The acupuncture improves the behavior of the model rats with post-stroke depression, repairs hippocampal neuronal damage, which is probably related to the contents of hippocampal monoamine neurotransmitters (NE, 5-HT and DA).


Subject(s)
Acupuncture Therapy , Animals , Depression , Hippocampus , Neurons , Neurotransmitter Agents , Rats , Rats, Sprague-Dawley , Stroke
12.
Chinese Acupuncture & Moxibustion ; (12): 1211-1213, 2019.
Article in Chinese | WPRIM | ID: wpr-776186

ABSTRACT

Professor - successively followed famous doctors of acupuncture and spleen-stomach disease, such as -, inherited their academic thoughts and clinical experience, and studied the classics to summarize and propose the clinical academic proposition regulating spleen-stomach differentiating meridians-collaterals. In clinical practice, professor focuses on individual differences of patients, carefully examines syndrome and refines acupoint selection; he pays attention to regulating spleen-stomach, and actively uses Zusanli (ST 36); he simultaneously uses acupuncture-moxibustion and acupoints with efficacy; he inherits traditional reinforcing and reducing methods, and extends the scope of acupoint diagnosis and treatment, while he emphasizes keeping spirit and treating spirit, and the combination of mind and , in order to improve clinical diagnosis and treatment effect.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Humans , Male , Meridians , Moxibustion , Spleen , Stomach
13.
Article in English | WPRIM | ID: wpr-771636

ABSTRACT

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.


Subject(s)
Abdomen , General Surgery , China , Drainage , Methods , Evidence-Based Medicine , Humans , Practice Guidelines as Topic , Societies, Medical , Surgical Wound Infection , Traumatology , Vacuum
14.
Article in Chinese | WPRIM | ID: wpr-773491

ABSTRACT

OBJECTIVE@#To investigate the relationship between necroptosis and apoptosis in MCET3-E1 cell death induced by glucocorticoids.@*METHODS@#MC3T3-E1 cells were incubated with 10-6 mol/L dexamethasone followed by treatment with the apoptosis inhibitor z-VAD-fmk (40 μmol/L) or the necroptosis inhibitor necrostatin-1 (40 μmol/L) for 2 h. At 72 h after incubation with dexamethasone, the cells were harvested to determine the cell viability using WST-1 assay and the rate of necrotic cells using annexin V/PI double staining; the percentage of apoptotic cells was determined using Hoechst staining. The mitochondrial membrane potential and the level of ATP in the cells were also evaluated. Transmission electron microscopy was used to observe the microstructural changes of the cells. The expressions of RIP-1 and RIP-3 in the cells were detected by Western blotting.@*RESULTS@#At a concentration of 10-6 mol/L, dexamethasone induced both apoptosis and necroptosis in MC3T3- E1 cells. Annexin V/PI double staining showed that inhibition of cell apoptosis caused an increase in cell necrosis manifested by such changes as mitochondrial swelling and plasma membrane disruption, as shown by electron microscopy; Hoechst staining showed that the percentage of apoptotic cells was significantly reduced. When necroptosis was inhibited by necrostatin-1, MC3T3-E1 cells showed significantly increased apoptosis as shown by both AV/PI and Hoechst staining, and such changes were accompanied by changes in mitochondrial membrane potential and ATP level in the cells.@*CONCLUSIONS@#In the process of dexamethasone-induced cell death, necroptosis and apoptosis can transform reciprocally accompanied by functional changes of the mitochondria.


Subject(s)
3T3 Cells , Adenosine Triphosphate , Animals , Apoptosis , Cell Death , Dexamethasone , Membrane Potential, Mitochondrial , Mice , Microscopy, Electron , Mitochondria , Necrosis
15.
Chinese Journal of Surgery ; (12): 807-811, 2019.
Article in Chinese | WPRIM | ID: wpr-800958

ABSTRACT

Objective@#To evaluate the progress and influence factors of asymptomatic osteonecrosis of the femoral head(ONFH).@*Methods@#MRI was performed on the contralateral hips of 174 patients with unilateral symptomatic ONFH who admitted at Department of Orthopaedics, the Second Affiliated Hospital of Xi′an Jiaotong University from January 2012 to December 2018. Eighty-three of 174 patients with unilateral ONFH were found suffering from contralateral ONFH(47.7%), of which 77 patients were followed up.There were 28 males and 49 females with age of 48.6 years (range: 21-73 years). The pathogenesis, ARCO classfication, areas and position of osteonecrosis were collected.Independent sample t test, χ2 test, Fisher exact test, multivariate Logistic regression were used to analyze the potential influence factors.@*Results@#Patients were followed up for 36.7 months. During the following up period, ARCO classification of 28 patients (36.4%) progressed.The progress of asymptomatic ONFH was not related to the gender, age and original ARCO classification, but related to the pathogenesis, position and area of osteonecrosis (all P<0.05).@*Conclusion@#The progress of asymptomatic osteonecrosis is related to the pathogenesis, position and area of osteonecrosis,but most of asymptomatic ONFH will not progress.

16.
Article in Chinese | WPRIM | ID: wpr-800305

ABSTRACT

Objective@#To investigate the effects of definitive repair surgery on health-related quality of life (HRQOL) in patients with bile duct injury after laparoscopic cholecystectomy (LC).@*Methods@#The retrospective case-control study was conducted. The clinicopathological data of 181 patients with bile duct injury caused by LC for benign gallbladder diseases who underwent definitive repair surgery and 50 patients without complications after LC for benign gallbladder diseases in the Mianyang Central Hospital from January 2000 to December 2017 were collected. There were 82 males and 99 females of 181 patients with bile duct injury, aged from 31 to 68 years, with an average age of 47 years. Definitive repair surgery was performed according to different types of bile duct injury, and questionnaire of HRQOL was conducted preoperatively and one year after operation. There were 18 males and 32 females of 50 patients without complications after LC, aged from 35 to 69 years, with an average age of 41 years. Questionnaire of HRQOL was conducted on LC patients without complications one year after operation. Observation indicators: (1) classification of bile duct injury; (2) intraoperative situations of definitive repair surgery; (3) postoperative situations of definitive repair surgery; (4) follow-up; (5) results of the SF-36 scale assessment. Follow-up was conducted by outpatient examination and telephone interview up to December 2018. Patients were reexamined liver function and color Doppler ultrasonography once every 6-12 months, and further magnetic resonance cholangiopancreatography (MRCP) or computed tomography examination to detect recurrence of anastomotic biliary stricture and cholangitis. Measurement data with normal distribution were expressed as Mean±SD, and comparison between groups was analyzed by the paired t test. Measurement data with skewed distribution were described as M (range), and count data were described as absolute numbers.@*Results@#(1) Classification of bile duct injury: of the 181 patients with bile duct injury, there were 64 cases of E1 type, 70 cases of E2 type, 35 cases of E3 type, 9 cases of E4 type, and 3 cases of E5 type. (2) Intraoperative situations of definitive repair surgery: all the 181 patinets with bile duct injury underwent definitive repair surgery successfully, including 61 undergoing end-to-end biliary anastomosis, 109 undergoing Roux-en-Y choledojejunostomy, 11 undergoing hemi-hepatectomy combined with Roux-en-Y anastomosis. There were 52 patients combined with hilar cholangioplasty. The operation time and volume of intraoperative blood loss of 181 patients were (190±126) minutes and 601.5 mL (range, 150.0-2 100.0 mL). There were 24 cases with blood transfusion and 18 cases with T-tube stent. (3) Postoperative situations of definitive repair surgery: 40 of 181 patients had complications, including 14 cases of incisional infection, 10 cases of bile leakage, 8 cases of perihepatic effusion, 7 cases of pulmonary infection, and 1 case of abdominal hemorrhage. The patient with postoperative abdominal hemorrhage underwent reoperation for hemostasis, and other patients with complications were cured after ultrasound-guided puncture and drainage or conservative treatment. Duration of postoperative hospital stay of 181 patients with bile duct injury was 12.6 days (range, 6.0-34.0 days). There was no perioperative death occurred. (4) Follow-up: 157 of 181 patients were followed up for 8.2-201.3 months, with a median follow-up time of 92.7 months. Twenty-eight patients had anastomotic stricture recurred, 16 of which were treated with reoperation, 10 were treated with endoscopic stent implantation, and 2 cases were treated with balloon dilatation in interventional department; the stricture was repaired again in all cases. Thirteen patients had recurrent cholangitis, showing no obvious anastomotic stricture on MRCP, and symptoms can be effectively controlled after conservative treatment. (5) Results of the SF-36 scale assessment: 181 patients with bile duct injury completed the SF-36 scales before definitive repair surgery, and 157 completed one year after definitive repair surgery. All the 50 patients without complications completed SF-36 scales one year after LC. The scores of HRQOL in physiological function, role functioning, somatic pain, general health, vitality, social function, emotional function, mental health, the scores of physical component summary, and mental component summary of 181 patients with bile duct injury before surgery were 79±15, 65±12, 40±17, 42±14, 59±20, 27±15, 48±23, 56±22, 60±11, and 56±11, respectively. The above indices one year after definitive repair surgery were 87±10, 78±15, 71±20, 64±20、68±19, 70±25, 67±21, 69±23, 71±13, 68±15, respectively. The above indices of 50 patients without complications one year after LC were 90±13, 81±20, 87±16, 72±20, 73±15, 86±17, 79±22, 77±19, 82±18, 79±18, respectively. The 181 patients with bile duct injury had significant elevation in above indices one year after definitive repair surgery (t=2.051, 2.016, 3.875, 3.014, 2.563, 3.225, 2.964, 2.357, 2.150, 2.203, P<0.05). The 50 patients without complications also had significant elevation in above indices one year after definitive repair surgery (t=2.817, 2.206, 3.641, 3.112, 3.202, 3.310, 3.011, 2.899, 2.150, 2.118, P<0.05). There were significant differences in the general health and mental health one year after definitive repair surgery between 181 patients with bile duct injury and 50 patients without complications (t=2.014, 2.011, P<0.05), and no significant difference in the physiological function, role functioning, somatic pain, vitality, social function, or emotional function between the two groups (t=0.852, 0.915, 0.907, 1.102, 1.284, 1.120, 0.863, 1.109, P>0.05).@*Conclusion@#Definitive repair surgery can significantly improve HRQOL in patients with bile duct injury caused by LC.

17.
Article in Chinese | WPRIM | ID: wpr-797914

ABSTRACT

Objective@#To study hemihepatectomy combined with a circular-stretching suturing technique in bile duct anastomosis in treatment of high level bile duct injuries (BDI).@*Methods@#From January 2000 to January 2018, eleven patients with high level BDI caused by laparoscopic cholecystectomy (LC) were treated in Mianyang Central Hospital with hemihepatectomy combined with a circular-stretching suturing technique in the bile duct anastomosis. The hilar confluence was involved in all these patients. A total of six patients had combined right hepatic artery injury with 1 having associated right portal vein injury. A total of five patients had developed right liver atrophy. The median time interval from LC to hepatectomy was 17.0(2.0~61.0) months. The number of previously attempted biliary repairs was 1~4 times (median 2 times). The bile duct anastomosis was performed by the circular-stretching suturing technique.@*Results@#There was no perioperative death. One patient underwent left hemihepatectomy and 10 patients right hemihepatectomy. Roux-en-Y hepaticojejunostomy was carried out in 9 patients, and bile duct end-to-end anastomosis in 2 patients. The operation time was (245.9±87.4) min, intraoperative blood loss (655.7±413.6) ml, and the median postoperative hospital stay 12.0(7.0~29.0) days. Five patients developed complications. The median follow-up was 47.0(15.0~89.0) months. One patient developed anastomotic stenosis and 1 patient had cholangitis. The remaining 9 patients were well.@*Conclusion@#After adequate preoperative preparation, patients who were treated with hemihepatectomy combined with the circular-stretching suturing technique for bile duct anastomosis to treat high level BDI achieved good results.

18.
Article in Chinese | WPRIM | ID: wpr-791477

ABSTRACT

Objective To study hemihepatectomy combined with a circular-stretching suturing technique in bile duct anastomosis in treatment of high level bile duct injuries (BDI).Methods From January 2000 to January 2018,eleven patients with high level BDI caused by laparoscopic cholecystectomy (LC) were treated in Mianyang Central Hospital with hemihepatectomy combined with a circular-stretching suturing technique in the bile duct anastomosis.The hilar confluence was involved in all these patients.A total of six patients had combined right hepatic artery injury with 1 having associated right portal vein injury.A total of five patients had developed right liver atrophy.The median time interval from LC to hepatectomy was 17.0 (2.0 ~ 61.0) months.The number of previously attempted biliary repairs was 1 ~ 4 times (median 2 times).The bile duct anastomosis was performed by the circular-stretching suturing technique.Results There was no perioperative death.One patient underwent left hemihepatectomy and 10 patients right hemihepatectomy.Roux-en-Y hepaticojejunostomy was carried out in 9 patients,and bile duct end-to-end anastomosis in 2 patients.The operation time was (245.9 ± 87.4) min,intraoperative blood loss (655.7 ±413.6) ml,and the median postoperative hospital stay 12.0(7.0 ~29.0) days.Five patients developed complications.The median follow-up was 47.0(15.0 ~ 89.0) months.One patient developed anastomotic stenosis and 1 patient had cholangitis.The remaining 9 patients were well.Conclusion After adequate preoperative preparation,patients who were treated with hemihepatectomy combined with the circularstretching suturing technique for bile duct anastomosis to treat high level BDI achieved good results.

19.
Article in Chinese | WPRIM | ID: wpr-823835

ABSTRACT

Objective To investigate the effects of definitive repair surgery on health-related quality of life (HRQOL) in patients with bile duct injury after laparoscopic cholecystectomy (LC).Methods The retrospective case-control study was conducted.The clinicopathological data of 181 patients with bile duct injury caused by LC for benign gallbladder diseases who underwent definitive repair surgery and 50 patients without complications after LC for benign gallbladder diseases in the Mianyang Central Hospital from January 2000 to December 2017 were collected.There were 82 males and 99 females of 181 patients with bile duct injury,aged from 31 to 68 years,with an average age of 47 years.Definitive repair surgery was performed according to different types of bile duct injury,and questionnaire of HRQOL was conducted preoperatively and one year after operation.There were 18 males and 32 females of 50 patients without complications after LC,aged from 35 to 69 years,with an average age of 41 years.Questionnaire of HRQOL was conducted on LC patients without complications one year after operation.Observation indicators:(1) classification of bile duct injury;(2) intraoperative situations of definitive repair surgery;(3) postoperative situations of definitive repair surgery;(4) follow-up;(5) results of the SF-36 scale assessment.Follow-up was conducted by outpatient examination and telephone interview up to December 2018.Patients were reexamined liver function and color Doppler ultrasonography once every 6-12 months,and further magnetic resonance cholangiopancreatography (MRCP) or computed tomography examination to detect recurrence of anastomotic biliary stricture and cholangitis.Measurement data with normal distribution were expressed as Mean±SD,and comparison between groups was analyzed by the paired t test.Measurement data with skewed distribution were described as M (range),and count data were described as absolute numbers.Results (1) Classification of bile duct injury:of the 181 patients with bile duct injury,there were 64 cases of E1 type,70 cases of E2 type,35 cases of E3 type,9 cases of E4 type,and 3 cases of E5 type.(2) Intraoperative situations of definitive repair surgery:all the 181 patinets with bile duct injury underwent definitive repair surgery successfully,including 61 undergoing end-to-end biliary anastomosis,109 undergoing Roux-en-Y choledojejunostomy,11 undergoing hemi-hepatectomy combined with Roux-en-Y anastomosis.There were 52 patients combined with hilar cholangioplasty.The operation time and volume of intraoperative blood loss of 181 patients were (190±126) minutes and 601.5 mL (range,150.0-2 100.0 mL).There were 24 cases with blood transfusion and 18 cases with T-tube stent.(3) Postoperative situations of definitive repair surgery:40 of 181 patients had complications,including 14 cases of incisional infection,10 cases of bile leakage,8 cases of perihepatic effusion,7 cases of pulmonary infection,and 1 case of abdominal hemorrhage.The patient with postoperative abdominal hemorrhage underwent reoperation for hemostasis,and other patients with complications were cured after ultrasound-guided puncture and drainage or conservative treatment.Duration of postoperative hospital stay of 181 patients with bile duct injury was 12.6 days (range,6.0-34.0 days).There was uo perioperative death occurred.(4) Follow-up:157 of 181 patients were followed up for 8.2-201.3 months,with a median follow-up time of 92.7 months.Twenty-eight patients had anastomotic stricture recurred,16 of which were treated with reoperation,10 were treated with endoscopic stent implantation,and 2 cases were treated with balloon dilatation in interventional department;the stricture was repaired again in all cases.Thirteen patients had recurrent cholangitis,showing no obvious anastomotic stricture on MRCP,and symptoms can be effectively controlled after conservative treatment.(5) Results of the SF-36 scale assessment:181 patients with bile duct injury completed the SF-36 scales before definitive repair surgery,and 157 completed one year after definitive repair surgery.All the 50 patients without complications completed SF-36 scales one year after LC.The scores of HRQOL in physiological function,role functioning,somatic pain,general health,vitality,social function,emotional function,mental health,the scores of physical component summary,and mental component summary of 181 patients with bile duct injury before surgery were 79±15,65±12,40±17,42±14,59±20,27±15,48±23,56±22,60±11,and 56±11,respectively.The above indices one year after definitive repair surgery were 87±10,78±15,71±20,64±20、68± 19,70 ± 25,67 ± 21,69 ± 23,71 ± 13,68 ± 15,respectively.The above indices of 50 patients without complications one year after LC were 90±13,81±20,87±16,72±20,73±15,86±17,79±22,77±19,82±18,79 ± 18,respectively.The 181 patients with bile duct injury had significant elevation in above indices one year after definitive repair surgery (t=2.051,2.016,3.875,3.014,2.563,3.225,2.964,2.357,2.150,2.203,P<0.05).The 50 patients without complications also had significant elevation in above indices one year after definitive repair surgery (t=2.817,2.206,3.641,3.112,3.202,3.310,3.011,2.899,2.150,2.118,P<0.05).There were significant differences in the general health and mental health one year after definitive repair surgery between 181 patients with bile duct injury and 50 patients without complications (t =2.014,2.011,P<0.05),and no significant difference in the physiological function,role functioning,somatic pain,vitality,social function,or emotional function between the two groups (t=0.852,0.915,0.907,1.102,1.284,1.120,0.863,1.109,P>0.05).Conclusion Definitive repair surgery can significantly improve HRQOL in patients with bile duct injury caused by LC.

20.
Pakistan Journal of Pharmaceutical Sciences. 2018; 31 (6): 2329-2332
in English | IMEMR | ID: emr-205070

ABSTRACT

Isopropylidene shikimic acid [ISA], a new drug derviatived from Shikimic Acid, had been proved to be effective in the cerebral protection after cerebral ischemia and reperfusion. But there was little research on the physical pharmacy and biopharmaceutical properties about the drug. In order to provide some useful data for the pharmaceutical development of ISA, the solubility, stability and Oil/Water partition coefficient [LogP] were determined by the classic preformulation study method, and the transmembrane performance of ISA was studied by Franz -diffusion cell method in vitro. The results showed that ISA was water-soluble with a solubility 32.52mg/ml, which could be improved to 44.32 mg/ml by 1% [w/v] sodium dodecyl sulfate; the LogP was -0.63; ISA was less stable in water but it was stable when pH greater than 6.0 and unstable when pH less than 6.0; the accumulated permeation rates at 1h were about 50% and more than 80% at 6h. Data obtained by the study indicated that the medium selection and pH control were important for liquid preparation of ISA, and avoiding dissolution and absorption in stomach was critical for the oral solid dosage forms. Mucosal drug delivery systems would be considered, according to the certain hydrophilic-lipophilic characters and good transmembrane capability

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